Each year, approximately 600,000 hysterectomy procedures are performed in the Untied States, totaling more than 5 billion dollars in medical expenses. Many different surgical methods are available for performing a hysterectomy, and the degree of intrusiveness and recovery time are dependent on the surgical method chosen. Typically, for non-endoscopic hysterectomies, the recovery time is approximately six weeks. As technology has progressed, there has been a movement for quicker, safer methods for performing hysterectomies.
Electrosurgical forceps, such as those disclosed in U.S. Pat. No. 7,232,440, utilize both mechanical action and electrosurgical energy to treat tissue. In electrosurgery, electricity alternates current through tissue held between two electrodes. The frequency at which the current alternates should generally be set at 100,000 cycles per second (often referred to as “radio” frequencies) or above. In bipolar electrosurgery, both the positive and ground electrodes are located at the site of surgery (e.g., a forceps wherein one lead is the positive electrode of a circuit and the other lead is the negative electrode of that circuit). In monopolar electrosurgery only the active electrode is in the wound, and the ground electrode is at another location on the patient's body.
The effect of the electrosurgical energy on tissue depends on the waveform of the electrosurgical energy. As is well known to those skilled in the art, the waveform may be manipulated to cut or vaporize tissue, coagulate tissue, or a mixture of both. Tissue dessication occurs when the electrode is in direct contact with the tissue, which may be achieved using several different waveforms.
The CDC has reported a significant increase in the proportion of laparoscopic assisted vaginal hysterectomies (LAVH) over the past decade. In a 1994 study comparing LAVH patients with patients undergoing total abdominal hysterectomies (TAH), it was shown that LAVH patients undergo longer surgical operations and more costly hospital stays, but they also stay in the hospital for significantly less time, have less pain during recovery, and are able to engage in significantly more postoperative activity sooner. Results from a 1997 study comparing patients undergoing LAVH to patients undergoing vaginal hysterectomies showed that although LAVH patients underwent longer, more costly surgery, there was significantly less blood loss associated with the LAVH procedures.
Numerous patents exist for surgical devices designed for endoscopic cholecystectomy; however, there are currently no dedicated devices for endoscopic pelvic surgery. Specifically, U.S. Pat. No. 4,493,320 shows a bipolar electrosurgical cautery snare; U.S. Pat. No. 5,569,244 shows loop electrodes for electrocautery for probes for use with a resectoscope; and U.S. Pat. No. 5,458,598 shows tripolar cutting forceps. The endoscopic cholecystectomy devices now in use are generally very slow, with small cutting/cauterizing areas requiring very high amounts of electricity and high temperatures, which can damage surrounding tissue and result in more time-consuming surgical procedures.